Medicaid Program Monitor

State of Louisiana; Baton Rouge (LA); On-site; USD 65,000 - 90,000; Full time

Job summary

Louisiana Department of Health is seeking a Program Monitor to lead provider monitoring, review financial and compliance records, and perform on-site assessments to ensure regulatory compliance and proper use of Medicaid funds.

The role emphasizes collaboration with fiscal and program teams to safeguard funding and ensure essential services for Louisiana nursing home residents.

Qualifications

• Six years of experience in developing, managing, or evaluating health or social service programs.
• Six years in any field plus three years in health programs or related areas.
• Bachelor’s degree plus three years in health program development/man-agement/evaluation.
• Advanced degree or JD plus two years in relevant health program experience.
• Educational substitution: 30 semester hours equals one year of experience; max 120 semester hours.

Responsibilities

• Oversees provider monitoring to ensure Medicaid compliance with requirements and regulations.
• Conducts desk reviews and on-site monitoring visits to evaluate performance and standards.
• Reviews cost reports and financial records for accuracy and compliance.
• Identifies deficiencies, investigates discrepancies, and coordinates corrective action plans.
• Prepares compliance reports and audit-ready documentation.
• Collaborates with fiscal, audit, and program teams to reconcile data and support updates.
• Monitors program performance and provider accountability to safeguard Medicaid funding and resident services.

Skills

Health program experience

Regulatory compliance

Monitoring & evaluation

Education

Bachelor’s degree + 3 years

Advanced degree/JD + 2 years

Job description

The mission of the Louisiana Department of Health is to protect and promote health and to ensure access to medical, preventive, and rehabilitative services for all residents of the State of Louisiana.

Learn more about Louisiana Department of Health

Are you detail-oriented and passionate about ensuring quality healthcare services? Join our team as a Program Monitor and play a critical role in safeguarding Medicaid-funded programs! In this position, you’ll lead provider monitoring efforts, review financial and compliance records, conduct on-site assessments, and collaborate with partners to ensure accountability and regulatory compliance. Your work will help protect essential healthcare funding, strengthen program integrity, and ensure Louisiana nursing home residents continue to receive the services they need. Apply today and make an impact!

• Six years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
• Six years of full-time work experience in any field plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
• A bachelor’s degree plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
• An advanced degree or a Juris Doctorate plus two years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services.

EXPERIENCE SUBSTITUTION:

Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

The official job specifications for this role, as defined by the State Civil Service, can be found here.

Job Duties

• Oversees provider monitoring activities to ensure compliance with Medicaid program requirements, state and federal regulations, and established policies.
• Conducts desk reviews and on-site monitoring visits to evaluate provider performance, operational practices, and compliance standards.
• Reviews cost reports, financial records, and supporting documentation to verify accuracy, completeness, and compliance with reporting and reimbursement requirements.
• Identifies compliance deficiencies, investigates discrepancies, and coordinates corrective action plans with providers to address findings.
• Prepares compliance reports, monitoring summaries, and supporting documentation while maintaining accurate, audit-ready records.
• Collaborates with fiscal, audit, and program teams to reconcile data, resolve compliance issues, and support policy updates and training initiatives.
• Monitors program performance and provider accountability to safeguard Medicaid funding, maintain audit readiness, and support the delivery of essential services to Louisiana nursing home residents.

Position-Specific Details

Location: Medical Vendor Administration / Rate Setting and Audit / East Baton Rouge Parish

Appointment Type: This position may be filled as aProbationary appointment, Promotional appointment, or Detail to Special Duty

Cost Center: 3052120201

Position Number(s): 50375592

Contact Information

Shambrielle Pooler

[e-mail]

LA Department of Health (LDH)

Division of Human Resources

PO Box 4818

Baton Rouge, LA 70821

225-342-6477

This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.

LDH supports Louisiana’s commitment to being a State as a Model Employer (SAME) by promoting the recruitment, hiring, and retention of individuals with disabilities.

Information on the Louisiana Works, Louisiana Rehabilitation Services is available here.

LDH is an equal opportunity employer and seeks to recruit a highly productive and diverse workforce and will provide equal employment opportunities to all employees and prospective employees. Employment decisions shall be based strictly on merit and without regard to religious or political beliefs, sex, race, or any other non-merit factor.